Depression and Incidence of Frailty in Older People From Six Latin American Countries |
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Authors: | A. Matthew Prina Brendon Stubbs Nicola Veronese Mariella Guerra Carolina Kralj Juan J. Llibre Rodriguez Martin Prince Yu-Tzu Wu |
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Affiliation: | 1. Social Epidemiology Research Group (AMP, Y-TW), Deparment of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King''s College London, London;2. Global Health Institute (AMP, MP), King''s College London, London;3. Department of Psychological Medicine (BS), Institute of Psychiatry, Psychology & Neuroscience, London;4. South London and Maudsley NHS Foundation Trust (BS, CK), London;5. National Research Council, Neuroscience Institute (NV), Aging Branch, Padua, Italy;6. Ambulatory of Nutrition (NV), IRCCS “S. de Bellis” National Institute of Gastroenterology–Research Hospital, Castellana Grotte, Bari, Italy;7. Institute of Memory, Depression and Disease Risk (MG), Lima, Peru;8. Facultad de Medicina Finlay-Albarran (JJLR), Medical University of Havana, Havana, Cuba |
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Abstract: | ObjectiveFrailty and depression are highly comorbid conditions, but the casual direction is unclear and has not been explored in low- and middle-income countries. The aim of this study was to investigate the potential impact of depression on incident frailty in older people living in Latin America.MethodsThis study was based on a population-based cohort of 12,844 people aged 65 or older from six Latin American countries (Cuba, Dominican Republic, Mexico, Venezuela, Puerto Rico, and Peru), part of the 10/66 cohort study. Two types of frailty measures were used: a modified Fried frailty phenotype and a multidimensional frailty criterion, which included measures from cognition, sensory, nutrition, and physical dimensions. Depression was assessed using EURO-D and International Classification of Diseases, Tenth Revision criteria. A competing risk model was used to examine the associations between baseline depression and incidence of frailty in the 3–5 years of follow-up, accounting for sociodemographic and health factors and the competing event of frailty-free death.ResultsDepression was associated with a 59% increased hazard of developing frailty using the modified Fried phenotype (subdistribution hazard ratio [SHR]: 1.59; 95% confidence interval [CI]: 1.40, 1.80) and 19% for multidimensional frailty (SHR: 1.19; 95% CI: 1.06, 1.33) after adjusting for sociodemographic factors, physical impairments, and dementia. The associations between depression and the multidimensional frailty criteria were homogenous across all the sites (Higgins I2 = 0%).ConclusionDepression may play a key role in the development of frailty. Pathways addressing the association between physical and mental health in older people need to be further investigated in future research. |
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Keywords: | Send correspondence and reprint requests to Yu-Tzu Wu, Social Epidemiology Research Group, Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF. Depression older age epidemiology frailty low- and middle-income countries |
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